Is ondansetron beneficial for psychosis associated with dementia?

BACKGROUND: This systematic review identified published studies that evaluated the use of ondansetron in individuals with psychosis associated with dementia.

METHODS: A literature search was conducted of PubMed, MEDLINE, EMBASE, PsycINFO, and Cochrane Collaboration databases for random­ized controlled trials (RCTs), cohort studies, and case reports that evalu­ated the use of ondansetron for individuals with psychosis associated with dementia. Bibliographic databases of published articles were also searched for additional studies.

RESULTS: A total of 4 studies were identified, all of which were open-label trials of ondansetron for psychosis associated with Parkinson’s disease. All trials showed improvements in visual hallucinations and paranoid ide­ations in most patients, as well as a modest improvement in functioning, but no evidence of cognitive improvement.

CONCLUSIONS: Ondansetron appears to have benefit in improving posi­tive symptoms of psychosis in individuals with Parkinson’s disease, but RCTs are needed before routine use is recommended. There is a paucity of evidence for the use of ondansetron for psychosis associated with other forms of dementia.

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